Ten years ago, when her pregnant daughter-in-law’s contractions began abruptly during a journey through mountains, away from any medical facility, Khaneefa helped deliver the baby. The Bakarwal family was in migration at that time.
When Ms. Khaneefa noticed that her daughter-in-law’s water had broken, she knew that they were on their own. “I had not learned the process from anyone but I could not let her die there,” she said. Hours later, the baby was delivered.
Since then, Ms. Khaneefa, 60, has assisted in the delivery of fourteen babies. “All the deliveries have been successful till now,” she said, smiling with pride. “Every baby was born healthy.”
Lending a helping hand
A mother of seven children, Ms. Khaneefa said that she understood how Bakarwal women felt when the labour began. “Women tend to get scared, that too when there is nobody to help,” she said adding that all her children were born in the forests.
Deliveries in hospitals involve the use of technological equipment and medicines to ensure safe childbirth and post-delivery care. Childbirth in hospitals is increasingly being done through pre-scheduled cesarean surgeries.
But for the Bakarwals, a hospital is nothing short of a luxury. “We do not have those options,” said Ms. Khaneefa. In the forests, she supervises deliveries using household essentials. “I immediately start massaging the women with hot oils,” she said. “That relieves their pain.”
Ms. Khaneefa has not only been helping women during the time of labour but has also been providing them with emotional support they need at that time. “I keep assuring them that the baby is safe,” she said.
The time of delivery as per Ms. Khaneefa varies in different women and sometimes even takes about ten hours to get completed. “I wait for the child to come out on its own,” she said.
Ms. Khaneefa believes that cutting the umbilical cord, the narrow tube connecting the baby to the placenta, is the trickiest part during the procedure and can be very risky for the child. “As soon as I cut the cord, I tie it with a pin,” she said.
Delivering a child is exhausting for the mother, requiring days of rest to recuperate. While the cultural convention in Kashmir is for new mothers to rest for 40 days after the delivery of a child, Bakarwal women start walking immediately.
“We keep moving forward,” said Ms. Khaneefa, adding that if the new mothers are extremely weak, they ride horses, “but we cannot stop.”
The Bakarwals are a Muslim nomadic community who have been rearing livestock and migrating within Jammu and Kashmir for centuries. They spend the summer months in the cooler Kashmir Valley and migrate to the Jammu region to protect their livestock from Kashmir’s harsh winters.
While Ms. Khaneefa did not have expertise when she assisted with the delivery of her grandchild, she gained experience over the years. “I learned that saving lives was really important,” she said.
“Death is really close to us”
After having spent much of her life walking the mountain ranges from Kashmir to Jammu, and back, and delivering babies during the journeys, Ms. Khaneefa has given up on her role as a midwife.
She chose to send her own daughter, 35-year-old Fehnaz, to a hospital in Rajouri from Mughal Road for the safe delivery of her first child, a boy, in a hospital in Rajouri.
Back at their camp along the Mughal Road, Ms. Khaneefa prayed for the safety of her daughter and grandchild. “We could not accompany her because of all the household items that we carry everywhere,” she said, adding that it was difficult for them to take the belongings to the hospital. Where would we even keep it all?”
Ms. Khaneefa believes that pregnant women of her community face health issues in the later stages of their lives because of not having a permanent place to stay. “We tend to get a terrible backache because we do not rest,” she said, “we never recover properly.”
While the lack of a permanent shelter deprives Bakarwal women of rest and recovery, lack of proper food and medicines in the mountains often causes weakness in the mother as well as the baby. “Sometimes, there is absolutely nothing to eat,” said Ms. Khaneefa.
Bakarwal women sometimes face complications at the time of delivery and cannot be treated by midwives. They require immediate medical help but long distances and lack of resources cause bigger problems including deaths that are undocumented.
“Reaching hospitals takes a lot of time,” said Ms. Khaneefa.
Recalling an incident from one of her journeys, Ms. Khaneefa said that once a woman had to be carried on a wooden log to the hospital. Due to the unavailability of transport, the family reached the hospital. “She was almost dying in pain and her baby got delivered as soon as the family reached the hospital,” she said.
The Bakarwal community was not familiar with the concept of family planning, said Ms. Khaneefa. On average, she said, each Bakarwal family had about ten children. “If they [administration] had created awareness about the issues, things would have been different,” she said.
Ms. Khaneefa believes that childbirth is better and safer at hospitals than in forests, as there are no facilities available there. “We do not feel worried when the doctors take responsibility for the women,” said Ms. Khaneefa.
However doctors who belong to other dominant ethic groups, as per Ms. Khaneefa, stigmatize the Bakarwal community and sometimes deny proper medical care.
Ms. Khaneefa hopes that things change in the near future for the women of her community. “Government should at least provide our community with one female doctor who travels with us to prevent pregnant women from health threats,” she said. “Death is really close to us.”